Painkillers and heroin; on the road to addiction

Sunday

Mar 23, 2014 at 2:00 AM

I have read with great interest, concern and self reflection recently about the alarming use of opioid pain medications leading to heroin use and consequent overdoses causing the deaths of many of the users.

Nelson Linscott

I have read with great interest, concern and self reflection recently about the alarming use of opioid pain medications leading to heroin use and consequent overdoses causing the deaths of many of the users.

Opioid dependence is rampant and it affects all social and economic classes, but how do these drugs find their way to the street, causing this scourge of addiction that leads to the more available and cheaper heroin? Pain clinics, physicians and hospitals prescribing to an uneducated pill-popping culture are the main sources.

Experts say most of those prescriptions are unnecessary. The United States makes up only 4.6 percent of the world's population, but consumes 80 percent of its opioids and 99 percent of the world's hydrocodone, the opiate that is in Vicodin (source: ABC News).

For 7½ years I was a part of that statistic. With medical conditions causing pain, I was prescribed methadone. I was told it was a great medication with few side effects and was truly appropriate for the pain I was in and my physical condition. Though I was suspicious that I was being prescribed methadone for pain when I only knew of its use in the treatment of heroin addiction, my trust for the prescriber prevailed. I began using it as prescribed, never abusing it, and I was stepped up the ladder of dosage increases. I felt better. Little did I know that I was cognitively impaired, emotionally flat and addicted. After quitting the drug, I regained my sanity but most of my life was in shambles. I went cold turkey off a moderate dosage of methadone without help, therapy or other drugs. I was in withdrawal for one year. If I had stayed in the Seacoast area, I may have never broken the bonds of methadone dependence. I had unknowingly moved to a county in Maine where opioid dependence is at record levels and no doctor in the county would refill my prescription. This may have saved my life. It was the toughest year of my 59 years.

After withdrawal, I stopped to evaluate my pain and my life. My pain level was approximately the same as when medicated but now I cared about it, I was aware, I could tell clearly where the pain was located and limit my activities so not to aggravate my condition. On methadone, I didn't care, I didn't feel, I was artificially happy but mentally incapacitated, though I wasn't aware of mental degradation. Everyone around me was painfully aware that something was wrong with me.

Should I have been on this medication? No, I should not have been. Physically, I was a wreck — bloated, barely breathing, in a fog. I was severely depressed and I still suffer from both depression and pain. Just to put one foot in front of the other was a chore and some days it still is. On opioids, every day is a sunny day no matter how bad your pain, life situations or what the weather is. In withdrawal and after, every day is a cold cloudy day of doom and gloom. It does get better, but it is a slow process. It is no wonder why people continue on these drugs or resort to a less expensive and plentiful substitute.

I believe that lenience in the prescribing of these medications is sometimes profit motivated without consideration for the patient. I am not saying all of it is, nor am I saying that pain medication isn't needed. Look at the statistics. Are U.S. citizens in so much pain they need most of the world's supply of pain medication? I believe not.

Illicit drug use can also start by the discovery of leftover opioids from surgeries, accidents and medical conditions, which can be found in many people's medicine cabinets by others who may be in pain or just want to be high. It is the overprescribing of opioids to a patient out of the range of his pain and the disposition of leftover medication making these drugs available to experimenters. It doesn't take long to become addicted and now that law enforcement and the DEA have clamped down on prescription drugs, they are too expensive and too hard to find on the street for the addicted. Your neighborhood heroin pusher is happy to step in and fill that void. It is supply and demand at work. Much of the problem comes from the greed of making the almighty dollar at any cost. Corporate drug manufacturers, clinics and others make billions selling these drugs. Their public relations people paint a much different picture than reality. Drug representatives with their sharp suits and dresses pull their drug samples in wheeled carry-on baggage carriers to visit most medical establishments as spin doctors selling their wares to the hospitals, clinics and doctors. The drug reps usually supply free lunch, glossy pamphlets and a coercive lunchtime spiel. I must emphasize not all clinics, hospitals and doctors are under the spell of these drug companies, and not all employees of poorly managed pain clinics are either, but enough are to cause the problem in America.

What can be done? If you are in chronic pain, I suggest you research your condition and, if prescribed a narcotic, understand its use is addictive, dangerous and life changing. Talk to your doctor. Do not blindly agree to a narcotic pain medication. Attempt to change your doctor's mind if he prescribes a narcotic. Narcotics should be the last resort. Maybe you think you are in more pain than you really are. I have witnessed many pain sufferers claim their pain is a 9 on a 0 to 10 scale. If you are a 9, I doubt you can walk in the doctor's office. Be truthful.

Never accept a prescription drug from a well-meaning friend or family member. It is not only illegal, it can start your addiction. Never take narcotics unless they are prescribed to you and you have had a thorough discussion with the prescriber, fully understanding what you are taking and how long you will have to take it. If you need help, ask for it immediately. There are medications available to help you through withdrawal. If you are a friend or family member of a person you perceive is having trouble with prescribed or illegal narcotics, intervene! If you aren't a part of the solution, you are part of the problem. Remember that a drug addict will tell you anything you want to hear to get what he wants or thinks he needs. You may make the addict upset in intervention, but it is much easier than planning his funeral. When he recovers he will thank you for it.

I casually and foolishly believed that narcotics would end my pain and make everything perfect again. I should have been more intelligent than that. We all have pain, but we as Americans believe there is a pill to fix anything and everything. Pain is a part of life. Pain is a symptom and removing it does not treat the root cause. Moderate pain is not an emergency. Opioids have made my life much tougher even though I am clean, but it beats the alternative — addiction and death.

Addiction does not limit its destruction to the individual but to all who know him, love him and work with him. Many times addiction hurts the family and friends of the addicted as much or more than it does the addict himself. I know firsthand and I am sorry. I apologize to those I disappointed and hurt. The problem of drug abuse and addiction is everyone's problem, not just the faults of the individual, doctors, clinics, hospitals, drug reps and drug manufacturers. In a time of sociological changes, unemployment, high prices, high rent and housing costs, people get desperate and turn to desperate ways of dealing with the stress of modern life. Talk to people; seek help if you need it. I know it isn't easy. It is downright hard. We are all in this problem together and together is how it must be solved.

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